Table 2.
The main and adjuvant therapies in post-stroke aphasia.
Methods | Major Characteristics | Advantages | Limitations | ||
---|---|---|---|---|---|
SLT (Speech and language therapy) | Conventional SLT | Facilitating communication with the environment in everyday life situations. | The most common rehabilitation method of PSA. If treatment is not conducted from the early phase of the stroke, then optimal benefits for the patient can be achieved in the chronic phase. |
The optimal intensity and dose of STL has not been determined. There is no consensus on the timing of treatment initiation and its continuation. |
[17,18] |
M-MAT (Multi-Modal Aphasia Therapy) |
The use of all verbal and non-verbal strategies available to the patient to increase the effectiveness of communicating with the environment. | Applied in the treatment of severe motor aphasia and/or transcortical sensory aphasia. | The need for further clinical trials on a larger group of PSA. | [19] | |
ICAP (The Intensive Comprehensive Aphasia Program) |
Applied in mild to moderate aphasias, from the subacute to the chronic stroke phase. | Intensive exercises individually adjusted to the disturbed functions, as well as exercises of speech functionality. Variety of techniques, including computer programs, psychoeducational techniques, and group activities. |
The need for further clinical trials on a larger group of PSA. | [20] | |
LIBT (Language Impairment-Based Therapy) |
Progressive training of impaired linguistic functions related to the level depending on the patient’s clinical picture (semantic, phonological, syntactic, lexical, and motor speech realization). | Applied in the treatment of various types of aphasia in each stage of the disease (from subacute to chronic). | The need for further clinical trials on a larger group of PSA. | [21] | |
CIAT (Constraint-induced aphasia therapy) |
Communicating only with the use of language, without the use of non-verbal forms of communication. Time-limited, intensive form of therapy that is conducted for 3–4 h a day for several days or weeks. |
Applied in the treatment of aphasia with partially preserved expressive language skills, regardless of the stage of the stroke (from subacute to chronic). | The need for further clinical trials on a larger group of PSA. | [22] | |
Cognitive neurorehabilitation | Cognitive disorders, in particular memory and concentration disorders, are related to language functions. | A beneficial effect on the independence of the PSA. | [23,24,25] | ||
Telerehabilitation | Using videoconference or telephone conversation in PSA therapy. | Important therapeutic tool for people who have limited access to conventional therapy for health; geographic or financial reasons. Strongly recommended in the literature, due to the increase in both the availability and effectiveness of therapy. |
Designing a therapeutic program using telerehabilitation requires consulting the skills and needs of PSA in order to eliminate all potential barriers related to technology. | [26,27] | |
Computer based management | The use of IT tools to conduct PSA therapy. | Variety of short- and long-term therapy. Low costs and effectiveness. Enabling therapy not only under the supervision of speech therapists, but also at home, under the supervision of people from the immediate surroundings. |
The need for further clinical trials on a larger group of PSA. | [28,29] | |
AAC (Augmentative and Alternative Communication) |
Non-verbal communication strategies due to the inability to communicate verbally. | Applied temporarily during the early stroke when the aphasic disorder is most severe, or for a longer period during the chronic stroke phase, when the language impairment is deeply established. Used in severe aphasia, mainly in motor, but also in sensory aphasia. |
The need for further clinical trials on a larger group of PSA. | [30] | |
MIT (melodic intonation therapy) |
Main emphasis on the prosody of speech by using the extra-linguistic features of spoken language, such as intonation, rhythm and emphasis | Applied in all phases of stroke, mainly in non-fluent Broca's aphasia, most often in patients with left hemispheric ischemic damage Reducing left hemisphere dependence by involving the right cerebral hemisphere, in particular pars traingularis and the sensorimotor region by tapping rhythmically with the left hand, which helps to better control mouth movements |
The need for further clinical trials on a larger group of PSA | [31,32] |